"Kamini balls", the street name for an illegal herbal drug which contains highly addictive opioids, often come packed inside small, harmless-looking glass bottles.
And if you know where to go, according to a team of Queensland researchers, there are grocery shops scattered throughout Australia's biggest cities selling Kamini from under the counter to people who are addicted to the drug and those who have no idea they're consuming opiates.
"The balls are kind of brownish, they're not formal-looking tablets we might expect to see from a reputable pharmaceutical source," Dr Jeremy Hayllar, from Alcohol and Drug Service, Metro North Health in Brisbane told 9news.com.au.
"They are literally round, grey-brown balls."
Hayllar is co-author of a just-released study, which investigated the problem in south-east Queensland.
Produced in India, and with a major active ingredient derived from the opium poppy, Kamini is covertly shipped across Australia's borders and distributed into Asian grocery stores across the country, the study claimed.
The Therapeutic Goods Administration (TGA) has prohibited Kamini, with a stark warning "these tablets pose a serious risk to your health and should not be taken".
Hayllar said grocery stores are illegally selling Kamini, and addiction to the illicit drug is a kind of invisible but "fairly widespread" problem in Australia.
A bottle of Kamini usually contains 40 balls, and some Queenslanders Hayllar encountered were swallowing 30 each day.
Hayllar said a 30-ball daily habit was the equivalent of taking a strong 60mg tablet of OxyContin, the notorious drug at the centre of America's pharmaceutical opioid crisis.
"It doesn't really matter which opioid is doing it, they all act on the same brain receptor," he explained.
"Once that brain receptor is getting its daily feed, if you like, if you try and take that away, the brain really does protest loudly."
It was the COVID-19 pandemic, which seriously throttled supply of Kamini into various stores across Queensland and drove prices up from $110 to $180 per bottle, that led to illegal product pinging the research team's radar.
During the pandemic, two Queenslanders in addiction who had been cut off from their Kamini sources sought help in opioid treatment centres.
They presented with typical opioid withdrawal signs which had been "difficult to explain", the study said, until the content of Kamini balls was determined.
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Hayllar said the team decided to check the records of 1500 patients at four public opioid treatment centres in south-east Queensland.
Cross-referenced, they found 10 more Kamini addicts.
The 12 patients were then interviewed, building a picture of Kamini use, addiction and distribution in south-east Queensland, and the peer-reviewed researched was published today in Drug & Alcohol Review.
Among other things, Kamini is pitched as a kind of sexual virility drug, curing erectile dysfunction, impotence and premature ejaculation.
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But Hayllar said most Kamini addicts he came into contact with had no idea Kamini contained opioids, only that it might help them work longer, and relieve stress or pain.
There were common factors in the group of 12 people using the substance, Hayllar said.
Eleven were Indian men, with a median age of 32.
The only non-Indian was a woman, who was a spouse of one of the men.
Some of the group worked in the rideshare industry, a sector notorious for toiling long hours and synonymous with migrant workers.
On average, those in the group were using 15 balls a day, with each Kamini dose delivering roughly 3mg of morphine.
The heaviest users were swallowing dozens of balls daily, Hayllar said, with three men having 30-a-day habits.
"It's something people get stuck in and find very hard to escape from," he said.
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Despite Hayllar's suggestion illegal selling of Kamini is "fairly widespread" in Australian cities, especially among the Indian migrant community, a Queensland Police Service spokesperson told 9news.com.au they "have not identified this substance as a trend or issue".
The spokesperson said Queensland Police "encourage anyone with information on the supply of dangerous drugs" to contact law enforcement agencies.
Australian Federal Police declined to comment on Kamini or claims in the study.
But Hayllar told 9news.com.au he was aware of Kamini being sold in North Queensland, Perth, Sydney and New Zealand, reflecting a hidden illicit drug scene.
The study reported people taking Kamini saying the opioid is "readily available" in Brisbane and that Kamini balls are "widely used amongst their peers".
"We know there's lots of clandestine stuff that goes on," Hayllar said.
"Because it's an under the counter activity … it's hard to determine how common it is."
The quantity of Kamini being sold in Australia is unknown, the study reported, as is the number of Australians who have developed untreated opioid addictions.
Readers seeking support and information about drug and alcohol can contact Lifeline on 13 11 14 or Beyond Blue on 1300 224 636 or the National Alcohol and Other Drugs Hotline on 1800 250 015.
